No abstract

Background Bacterial vaginosis (BV) is a proinflammatory genital condition associated with adverse reproductive health outcomes, including increased HIV incidence. However, BV recurrence rates are high following standard antibiotic treatment. While the composition of the vaginal microbiota prior to BV treatment may be linked to BV recurrence, it is unclear whether the preceding genital immune milieu is predictive of treatment success. Methods Here we assessed whether baseline vaginal soluble immune factors or the composition of the vaginal microbiota predicted treatment success one month after metronidazole treatment in two separate cohorts of women with BV, one in the US and one in Kenya; samples within 48 hours of BV treatment were also available for the US cohort. Results Neither soluble immune factors nor the composition of the vaginal microbiota prior to BV treatment were associated with treatment response in either cohort. In the US cohort, although the absolute abundances of key vaginal bacterial taxa pre-treatment were not associated with treatment response, participants with sustained BV clearance had a more pronounced reduction in the absolute abundance of Gardnerella vaginalis immediately following treatment. Conclusions Pre-treatment immune and microbial parameters were not predictive of BV treatment success in these clinical cohorts.